| NPI | 1720484322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NE 1802) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IA 072510) |
| 225X00000X Occupational Therapist (Licence: MO 2014013364) | |
| Enumeration Date | 2014-11-08 |
| Last Update Date | 2014-11-08 |