| NPI | 1417396177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MD T00270) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: DE U2-0001376) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |