| NPI | 1477391803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 125200) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 216309) |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2024-11-21 |