| NPI | 1982034146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: LA OTT200310) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: LA OTT200310) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2013-11-25 |