| NPI | 1821340944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: FL OT14713) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT14713) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2018-12-10 |