| NPI | 1861800260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL 18415) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MO 2014022930) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2021-08-27 |