| NPI | 1124404108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL 16716) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: SC 3478) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2021-08-19 |