| NPI | 1316585318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 20052) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 023809) |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2024-03-10 |