| NPI | 1003232240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 115900) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: TX 115900) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-13 |