| NPI | 1093168403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 10620) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 213957) |
| 224Z00000X Occupational Therapy Assistant (Licence: FL OTA 15257) | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-12-23 |