| NPI | 1093142333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AR OTR2638) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 115647) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |