| NPI | 1861813198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 6869) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 021127-1) |
| 225X00000X Occupational Therapist (Licence: FL 18141) | |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2017-06-23 |