| NPI | 1750406062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 8701) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 007707) |
| 225X00000X Occupational Therapist (Licence: MA 8932) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2019-11-19 |