| NPI | 1831510288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: OR 303310) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL 12517) |
| 224Z00000X Occupational Therapy Assistant (Licence: AZ 5526) | |
| Enumeration Date | 2014-01-01 |
| Last Update Date | 2014-01-01 |