NPI | 1952318677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: PA OC010946) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 04589) |
Enumeration Date | 2006-08-02 |
Last Update Date | 2013-10-03 |