| NPI | 1699230029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36003202A) |
| 225XH1200X Occupational Therapist, Hand | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2024-08-08 |