| NPI | 1033703228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TN 3539) |
| Additional Taxonomies | 226000000X Recreational Therapist Assistant (Licence: NY 010450) |
| Enumeration Date | 2021-02-27 |
| Last Update Date | 2021-02-27 |