| NPI | 1952077489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201007638) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: MI 201705116) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-23 |