| NPI | 1336396720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119004761) |
| Additional Taxonomies | 225XH1200X Occupational Therapist Hand (Licence: VA 0119004761) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2019-08-14 |