| NPI | 1174270854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA 7440) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 216888) |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2026-03-24 |