| NPI | 1508334079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL 16890) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2020-10-27 |