| NPI | 1912461369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TN 0478) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TN 1428) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |