| NPI | 1093849911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: VA 1017102) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-08 |