| NPI | 1609034255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ OTH-004134) |
| Additional Taxonomies | 225XH1200X Occupational Therapist Hand (Licence: AZ OTH-004134) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2023-05-25 |