| NPI | 1225698038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA OTA4040) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NC 12522) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2019-06-14 |