NPI | 1366817124 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 120849) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT 15233) |
Enumeration Date | 2015-12-04 |
Last Update Date | 2021-07-19 |