| NPI | 1376904318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT 60632584) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: WA OT60632584) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2021-01-26 |