| NPI | 1487050837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA 13717) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2019-11-25 |