NPI | 1528256476 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 8790) |
Enumeration Date | 2007-10-04 |
Last Update Date | 2019-04-15 |