| NPI | 1669625315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 5991) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL 10771) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |