| NPI | 1104330679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 17203) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN 5036) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |