| NPI | 1164883856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 16427) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NV 16-0747) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2018-03-17 |