| NPI | 1003482613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 24461) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 10318) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2024-05-13 |