| NPI | 1659724771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: TX 112360) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 112360) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |