| NPI | 1568413847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist Hand (Licence: OR 1041100414) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 1023386) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2009-01-06 |