| NPI | 1710693635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC019004) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2024-02-27 |