| NPI | 1760999379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NY 008820-1) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA po008390) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2019-08-27 |