| NPI | 1114322674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA OT13766) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT60203079) |
| 225X00000X Occupational Therapist (Licence: OR 282234) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2015-10-20 |