| NPI | 1639367766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: UT 12260704-4201) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: OK 1526) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2021-12-17 |