| NPI | 1245502111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131000967) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA 11284) |
| 224Z00000X Occupational Therapy Assistant (Licence: WV C1826) | |
| 224Z00000X Occupational Therapy Assistant (Licence: MD A01886) | |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |