| NPI | 1073681987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TN 1026) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: KY KYA2709) |
| 224Z00000X Occupational Therapy Assistant (Licence: FL 10074) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |