| NPI | 1831526904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: KY 268531) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TN 2248) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2021-09-01 |