| NPI | 1962791046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: PA OC-000201L) |
| Additional Taxonomies | 225XH1200X Occupational Therapist Hand (Licence: PA OC000201L) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |