| NPI | 1962483941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY 135492) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: KY R-1403) |
| 225XH1200X Occupational Therapist, Hand | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2023-12-20 |