| NPI | 1659608701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT.006685) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 011004791) |
| 225X00000X Occupational Therapist (Licence: NY 6382902) | |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2009-11-11 |