| NPI | 1720569122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 215010) |
| Additional Taxonomies | 224ZF0002X Occupational Therapy Assistant, Feeding, Eating & Swallowing (Licence: TX 215010) |
| 225XG0600X Occupational Therapist, Gerontology (Licence: TX 215010) | |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |