| NPI | 1669066007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY 170656) |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification (Licence: KY 170656) |
| 225XF0002X Occupational Therapist, Feeding, Eating & Swallowing (Licence: KY 170656) | |
| 225XH1200X Occupational Therapist, Hand (Licence: KY 170656) | |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-02-25 |