| NPI | 1033753140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: IL 057005481) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-19-103388) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2021-02-18 |