| NPI | 1649614371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NY 000604-1) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA10692) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |