| NPI | 1255790077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA 61503398) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2024-10-24 |