| NPI | 1417735788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: PA OP010186) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09174000) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |