NPI | 1043083488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 4089) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 28298) |
235Z00000X Speech-Language Pathologist, (Licence: CA 13306) | |
Enumeration Date | 2023-11-06 |
Last Update Date | 2023-11-06 |