NPI | 1831770882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 09257) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A4265) |
Enumeration Date | 2021-04-20 |
Last Update Date | 2021-04-20 |