| NPI | 1871921239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XN1300X Occupational Therapist, Neurorehabilitation | |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2014-08-19 |