| NPI | 1669857140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: CT 6194) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 119469) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2025-01-21 |