| NPI | 1700022423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 210177) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MS TA2096) |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2008-12-30 |