| NPI | 1730516402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2011020747) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 016620) |
| 225X00000X Occupational Therapist (Licence: DC OT010000914) | |
| 225X00000X Occupational Therapist (Licence: MD 07218) | |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-09-26 |