| NPI | 1225574296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 212942) |
| Additional Taxonomies | 224ZR0403X Occupational Therapy Assistant, Driving and Community Mobility (Licence: TX 212942) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |