| NPI | 1316385263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 13457) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC 010000875) |
| 225X00000X Occupational Therapist (Licence: TX 115286) | |
| 225X00000X Occupational Therapist (Licence: PA Oc015226) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2017-10-16 |