| NPI | 1669909016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT17723) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: FL TT14766) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2017-05-16 |