| NPI | 1528413648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA 3641) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: GA OTA002061) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2019-04-29 |