| NPI | 1649512831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IA 01363) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 4883) |
| 225X00000X Occupational Therapist (Licence: CT 003677) | |
| 225X00000X Occupational Therapist (Licence: NY 016251-1) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |