| NPI | 1891941852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 04232) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC ot912) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2016-12-09 |