| NPI | 1568791606 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: NH 2492) | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 10007) | 
| Enumeration Date | 2009-12-21 | 
| Last Update Date | 2023-12-21 |