| NPI | 1881815793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 13357) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT00004127) |
| 225XH1200X Occupational Therapist Hand (Licence: NH 1839) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2019-10-21 |