| NPI | 1487253795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201013587) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: CO 0006583) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2023-09-20 |