| NPI | 1134366321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MD A00797) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA OP006152) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-01-09 |