| NPI | 1801118450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NC 7413) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2019-05-27 |