| NPI | 1609971456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist Hand (Licence: AK PHYO2299) |
| Additional Taxonomies | 225XH1200X Occupational Therapist Hand (Licence: WY OTR-462) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2023-11-27 |