| 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 |