| NPI | 1093326415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: IN 32002290A) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IN 32002290A) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |