| NPI | 1215392568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 119244) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN 5323) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2025-04-29 |