| NPI | 1649445412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA OTA 1678) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA 9663) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |