| NPI | 1811065857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT60564371) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: TX 111425) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2019-10-04 |