| NPI | 1962503953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD AA228726) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA OT5525) |
| 225XH1200X Occupational Therapist, Hand (Licence: CA 9105000156) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-08 |