| NPI | 1134586761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 3740) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 3740) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2020-02-06 |