| NPI | 1073041968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA12121) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: FL OTA12121) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-05-03 |