| NPI | 1134408651 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: TX 109571) | 
| Additional Taxonomies | 225X00000X Occupational Therapist | 
| Enumeration Date | 2011-08-15 | 
| Last Update Date | 2024-12-09 |