| NPI | 1679861710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IL 056009406) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY R4859) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2011-12-13 |