| NPI | 1124279518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 11073) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 211161) |
| Enumeration Date | 2008-10-04 |
| Last Update Date | 2015-07-14 |