| NPI | 1144691114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA15112) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IN 32002227A) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2017-05-31 |