| NPI | 1861792749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT9490) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: FL OT9490) |
| 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: FL OT9490) | |
| 225CA2500X Rehabilitation Counselor, Assistive Technology Supplier (Licence: FL OT9490) | |
| 225XE0001X Occupational Therapist, Environmental Modification (Licence: FL OT9490) | |
| 225XG0600X Occupational Therapist, Gerontology (Licence: FL OT9490) | |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: FL OT9490) | |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-10-26 |