| NPI | 1619458734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL 15343) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 214627) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2021-03-18 |