| NPI | 1225276710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 112894) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MS OT2236) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |