| NPI | 1144494121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT8416) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: TX 111127) |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2025-08-07 |