| NPI | 1679861082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: LA Z20286) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 207608) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |