| NPI | 1023991098 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 28143) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 29926) |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-09-12 |