| NPI | 1831718410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: GA OTA002654) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA13276) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-04-13 |