| NPI | 1235681297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2019-03-04 |