| NPI | 1376267500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: AZ OTA-001892) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: AZ 001892) |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2022-09-30 |