| NPI | 1710375886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 9025) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OH OTA006309) |
| 224Z00000X Occupational Therapy Assistant (Licence: GA OTA001712) | |
| 224Z00000X Occupational Therapy Assistant (Licence: CA 2765) | |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2019-07-02 |