| NPI | 1437720893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09197500) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA OP009919) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-07-07 |