| NPI | 1902011968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1203) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 3837) |
| 225X00000X Occupational Therapist (Licence: MN 103000) | |
| 225X00000X Occupational Therapist (Licence: TX 111398) | |
| 225X00000X Occupational Therapist (Licence: AL 2485) | |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2014-10-03 |