| NPI | 1962536722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 290) |
| Additional Taxonomies | 225XH1200X Occupational Therapist Hand (Licence: ND 290) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2022-12-30 |