| NPI | 1114180700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX p0356) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: TX p0356) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2014-10-15 |