| NPI | 1215116017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA OT2513) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA OP003008L) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2020-01-22 |