| NPI | 1194458513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA OT25151) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-07-04 |
| Last Update Date | 2024-09-09 |