| NPI | 1235488487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NY 008054) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: GA 001646) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2018-10-30 |