| NPI | 1982252144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NV OTA-2398) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CO OTA.0001242) |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2019-10-04 |