| NPI | 1407989692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: AZ 4447) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NM 1712) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2010-07-22 |