NPI | 1104092121 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 121433) |
Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
Enumeration Date | 2008-04-30 |
Last Update Date | 2024-06-12 |