| NPI | 1568874063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA 11467) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2024-07-22 |