| NPI | 1134552722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 8813) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL 12319) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-19 |