| NPI | 1558483099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 109372) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2017-04-13 |