| NPI | 1831690361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201001705) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2018-02-21 |