| NPI | 1972691830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 109695) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: TX 109695) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-11-17 |