| NPI | 1316585557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 12954) |
| Additional Taxonomies | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: CA 12954) |
| 225XG0600X Occupational Therapist Gerontology (Licence: CA 12954) | |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |