| NPI | 1528307634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MA 2991) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: RI OTA00366) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-02-08 |