| NPI | 1932566221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: KY A3195) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OH OTA.03191) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |