| NPI | 1417938440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 0456) |
| Additional Taxonomies | 225XH1200X Occupational Therapist Hand (Licence: NC 9105001166) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2014-06-16 |