| NPI | 1326584871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 16303) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 5698-26) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |