| NPI | 1881019859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 4965) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2019-02-13 |