| NPI | 1972852721 |
|---|---|
| Professional Name | N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OT-2226) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2019-11-18 |