| NPI | 1285063313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NM 4210) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TN OTA0000002226) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2020-01-13 |