| NPI | 1699097840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 120961) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: GA OT006834) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2024-03-27 |