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 |