| 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 |