| NPI | 1932272283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 109631) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 109631) |
| 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: TX 109631) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-04-15 |