| NPI | 1033132550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist Hand (Licence: KY 133548) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: KY R3317) |
| 225X00000X Occupational Therapist (Licence: KY R3317) | |
| 225XH1200X Occupational Therapist Hand (Licence: KY R3317) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-04-07 |