| NPI | 1720413669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131001209) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: 0131001209) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2018-09-14 |