| NPI | 1215383617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AL 4269) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: MS OT3164) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2017-02-21 |