| NPI | 1477927879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: KS 18-01178) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MS TA3046) |
| 224Z00000X Occupational Therapy Assistant (Licence: TX 213589) | |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2015-11-23 |