| NPI | 1831648047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH 11759) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OH 5788) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2021-10-07 |