| NPI | 1922535624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: ME OA4088) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA OP008369) |
| 224Z00000X Occupational Therapy Assistant (Licence: WV C2059) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2023-10-20 |