| NPI | 1275186769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 21409) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2026-03-24 |