| NPI | 1023025293 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: FL OT8514) | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT8514) | 
| 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: FL OT8514) | |
| Enumeration Date | 2006-08-01 | 
| Last Update Date | 2025-09-11 |