| NPI | 1336596436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 4543) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: SC 2452) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |