| NPI | 1366719353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 006067-1) |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2022-04-07 |