| NPI | 1306620133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA 20732) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 20732) |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2023-10-20 |