| NPI | 1821222977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2005010642) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OK 1512) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |