| NPI | 1851604888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 668) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119004943) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2010-07-19 |