| NPI | 1730413352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 7313) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 3443) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |