| NPI | 1750504940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 04257) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DE U1-0000596) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-08 |