| NPI | 1801904735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 004581) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 989520) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |