| NPI | 1710402656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 4819) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: CT 4819) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2017-08-11 |