| NPI | 1457722688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119006748) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: FL OT18510) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2025-05-04 |