| NPI | 1093245805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CT 1778) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 8813) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |