| NPI | 1164000204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation |
| 225XH1200X Occupational Therapist, Hand | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2025-11-19 |