| NPI | 1154767796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WI 4581-27) |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications (Licence: WI 4581-27) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |