NPI | 1780235754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT21109) |
Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA15002) |
Enumeration Date | 2019-09-21 |
Last Update Date | 2020-10-14 |