| NPI | 1073572467 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: FL OT25718)  | 
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: NY 009876-1)  | 
| Enumeration Date | 2006-03-23 | 
| Last Update Date | 2025-01-07 |