| NPI | 1992357792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NH 0812) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09164500) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |