| NPI | 1902018435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT10413) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: FL OT10413) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2011-04-05 |