| NPI | 1356139208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: CA 116668) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 116668) |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2026-07-15 |