| NPI | 1053609024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT60072350) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2019-07-22 |