| NPI | 1154829372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: AZ 5309) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CA OTA4171) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |