| NPI | 1871736827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AL OT2528) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MS OT1446) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2009-04-07 |