| NPI | 1326316639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 13159) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT60247215) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2014-10-30 |