| NPI | 1003044132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 9874) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: HI 925) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-26 |