| NPI | 1851466700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 110825) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 110825) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2009-06-22 |