| NPI | 1467972059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09138300) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 009280-1) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2017-06-23 |