| NPI | 1376126516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WV C2351) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MD A02877) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2021-05-05 |