| NPI | 1649767914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: AL 3984) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: AL 3984) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: AL 3984) | |
| Enumeration Date | 2018-04-22 |
| Last Update Date | 2018-04-22 |