NPI | 1902289317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 003398) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 11046) |
225X00000X Occupational Therapist (Licence: RI OT0038) | |
Enumeration Date | 2015-07-02 |
Last Update Date | 2015-07-02 |