| NPI | 1013146943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 4334) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 3069) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2016-06-20 |