| NPI | 1922856160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NC 15812) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: WY OTA-1758) |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |