| NPI | 1013463082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: OR 355593) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 16087) |
| 101Y00000X Counselor | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2024-06-19 |