| NPI | 1730374091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119002941) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC OT980) |
| 225X00000X Occupational Therapist (Licence: MD 05474) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |