| 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 |