| NPI | 1033733233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: CA 53896) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: CA 4093-T) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |