| NPI | 1912232570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: OR 382931) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: OR 16588) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2021-04-21 |