| NPI | 1891216800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WA 0000358) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: WA 00000358) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-07-21 |