| NPI | 1417439662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 209157) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: 209157) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |