| NPI | 1710340435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 121947) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 39446) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-08-14 |