| NPI | 1962423137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WI 1828-27) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 4662-26) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-10-15 |