NPI | 1205390879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA OT21498) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-01-28 |
Last Update Date | 2021-02-08 |