| NPI | 1235477282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 7802) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MI 2856224) |
| Enumeration Date | 2013-01-26 |
| Last Update Date | 2013-01-26 |