| NPI | 1134468002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CT 0013388) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MA 3586) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2013-02-12 |