| NPI | 1730577859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MD A03072) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2022-07-27 |