| NPI | 1174928535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: VA 0119009259) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 4321) |
| 225X00000X Occupational Therapist (Licence: MA 13746) | |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2022-02-08 |