| NPI | 1649747668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA 4593) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NV 18-1444) |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |