NPI | 1669597159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WV 1105) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 05553) |
225X00000X Occupational Therapist (Licence: PA oc010354) | |
Enumeration Date | 2007-03-21 |
Last Update Date | 2007-07-08 |