| 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 |