| NPI | 1679770572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: OR 1008623) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: WA ocoooo1012) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2007-07-08 |