| NPI | 1407169188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: TX 111029) |
| 225X00000X Occupational Therapist (Licence: TX 111029) | |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2011-06-05 |