| NPI | 1184181505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT61136191) |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2025-03-04 |