| NPI | 1902109606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: SC 2771) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NC 6068) |
| Enumeration Date | 2010-12-19 |
| Last Update Date | 2011-01-07 |