| NPI | 1285105627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT60633464) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 353557) |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2023-06-23 |