| NPI | 1194062083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 210118) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NM 2974) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2023-08-23 |