| NPI | 1275988842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA13846) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CA OTA3815) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2023-10-15 |