| NPI | 1184885394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist Hand (Licence: AZ 2123) |
| Additional Taxonomies | 225XN1300X Occupational Therapist Neurorehabilitation (Licence: AZ 2123) |
| 225XR0403X Occupational Therapist Driving and Community Mobility (Licence: AZ 2123) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-06-19 |