| NPI | 1700448123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: OR 423141) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 423141) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2021-10-30 |