| NPI | 1780065888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 213337) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 404045) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-10-14 |