| NPI | 1427751601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2023-04-04 |