| NPI | 1508928136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XN1300X Occupational Therapist, Neurorehabilitation |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XH1200X Occupational Therapist, Hand | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2025-09-11 |