| NPI | 1013602481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA 61323675) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 24240) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |