| NPI | 1790957728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH OT4906) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2018-07-31 |