| NPI | 1265209118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 19325) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 121479) |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2025-02-10 |