| NPI | 1053564872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: CA 19391) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: TX 110584) |
| 225XH1200X Occupational Therapist, Hand (Licence: VA 0119007291) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2020-10-06 |