| NPI | 1770891087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: KY 135808) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY R4592) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2019-04-11 |