| NPI | 1225427552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 102834) |
| Additional Taxonomies | 225XR0403X Occupational Therapist, Driving and Community Mobility (Licence: TX 102834) |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-01-09 |