| NPI | 1184177966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 18854) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SD 0978) |
| 225X00000X Occupational Therapist (Licence: CO OT0005458) | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2018-07-27 |