| NPI | 1336777408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 224ZR0403X Occupational Therapy Assistant Driving and Community Mobility |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |