| NPI | 1609353085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 125410) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT007165) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2025-03-03 |