| NPI | 1255790150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 122639) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 16020) |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2024-11-20 |