| NPI | 1861723736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: OR 1003914) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NE 318) |
| 224Z00000X Occupational Therapy Assistant (Licence: WA OC60438346) | |
| Enumeration Date | 2010-01-16 |
| Last Update Date | 2018-06-13 |