| NPI | 1447594064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224ZF0002X Occupational Therapy Assistant, Feeding, Eating & Swallowing (Licence: ID OTA-117) |
| Additional Taxonomies | 224ZE0001X Occupational Therapy Assistant, Environmental Modification |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |