| NPI | 1912162447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 004879) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OK 1191) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |