NPI | 1043646102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 172V00000X Community Health Worker |
225800000X Recreation Therapist | |
Enumeration Date | 2013-09-20 |
Last Update Date | 2023-09-14 |