| NPI | 1326309873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MO 2010015742) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IL 057.003235) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |