| NPI | 1679893515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0004808) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: n/a) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2018-03-17 |