| NPI | 1235539057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: UT 225X00000X) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: UT 225XH1200X) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: UT 225XP0019X) | |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2014-08-28 |