| NPI | 1245757087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 303545) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT60902728) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2021-04-20 |