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 |