| NPI | 1104027044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: AZ 2886) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NC 6200) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-08 |