| NPI | 1376704593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist Hand (Licence: AZ 2782) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: AZ 2782) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2018-03-17 |