| NPI | 1538418041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 211741) |
| Additional Taxonomies | 247200000X (Licence: TX 89411) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2018-12-12 |