| NPI | 1366803090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 10197) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CA 3477) |
| 224Z00000X Occupational Therapy Assistant (Licence: TX 213779) | |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |