| NPI | 1497406524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL 17247) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL 420414) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-01-14 |