| NPI | 1063146389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WV C2443) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131002455) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |