| NPI | 1760727986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SC 6907) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6907) |
| 225XH1200X Occupational Therapist, Hand (Licence: SC 6907) | |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2012-11-28 |