NPI | 1497803944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MS OT2248) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MS PTA3621) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2011-07-06 |