| NPI | 1235381278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 124654) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 210005) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2024-07-09 |