| NPI | 1902488141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: OH OT011984) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY 270122) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2022-06-21 |