| NPI | 1992249957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY 169255) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31006215A) |
| Enumeration Date | 2016-12-10 |
| Last Update Date | 2016-12-10 |