| NPI | 1922519545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: TX 117009) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1279000) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 117009) | |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2023-05-10 |