| NPI | 1013172998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: AZ 4164) |
| Additional Taxonomies | 376G00000X Nursing Home Administrator (Licence: CO NHA.0002998) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2024-08-15 |