| NPI | 1366866295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 5674) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: NV 14-0450) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2023-08-09 |