| NPI | 1124400700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: IN 32002878A) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: KY BOTOTA00218998) |
| 224Z00000X Occupational Therapy Assistant (Licence: OH OTA.06134) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2015-06-19 |