| NPI | 1114296225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NV 13-1205) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA OP000414L) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2018-08-03 |