NPI | 1417411984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 21128) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-01-29 |
Last Update Date | 2020-08-24 |