| NPI | 1194173088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NM 3320) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 213257) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |