| NPI | 1720299621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: WA OT00003604) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: PA OC010292) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2016-07-22 |