| NPI | 1932233814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 5402) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 010625) |
| 225XH1200X Occupational Therapist, Hand (Licence: AZ 5402) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2024-02-18 |