| NPI | 1588247373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131000254) |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2021-04-30 |