NPI | 1306108873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 8304) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 003443) |
376G00000X Nursing Home Administrator (Licence: CT 001929) | |
Enumeration Date | 2012-06-11 |
Last Update Date | 2012-06-11 |