| NPI | 1356572978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 113162) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 113162) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-10-20 |