| NPI | 1811281017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: RI OTA00529) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MA 3399) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-07 |