| NPI | 1649839457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 215686) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 008954) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |