| NPI | 1114378320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131001265) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2025-05-13 |