| NPI | 1922391614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 113847) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 11845) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2011-05-27 |