| NPI | 1447595772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: RI OTA00336) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: RI MT00949) |
| 225X00000X Occupational Therapist (Licence: MA 2618) | |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |