| NPI | 1407076755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NY 006615-1) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 209687) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2023-05-23 |