| NPI | 1265556732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: RI ota00373) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MA 3006) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |