| NPI | 1770515611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NE 1203) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: KY 133840) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-02-15 |