| NPI | 1497038103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: TX 98550) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 210657) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2024-07-12 |