| NPI | 1952816860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT010016) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC015406) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-14 |