| NPI | 1740694512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 211456) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OK 2157) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2024-05-29 |