| NPI | 1801070453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: SC 2569) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 209614) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |