| NPI | 1255732087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224ZL0004X Occupational Therapy Assistant, Low Vision (Licence: NC 9300) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NC 9300) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |