| NPI | 1790182319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 4941) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MS OT2912) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |