| NPI | 1952671901 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: 293813OT) | 
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: OR 2542) | 
| Enumeration Date | 2012-01-09 | 
| Last Update Date | 2019-04-25 |