| NPI | 1447789888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver |
| Additional Taxonomies | 224ZR0403X Occupational Therapy Assistant, Driving and Community Mobility |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |