NPI | 1689900664 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: MT OTP-OT-LIC-7773) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MT OTP-OT-LIC-7773) |
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
Enumeration Date | 2009-10-26 |
Last Update Date | 2021-09-27 |