| NPI | 1932372810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201000918) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 1899026) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2012-09-24 |