| NPI | 1639112071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 104330) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: TX 1041100564) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-10-04 |