| NPI | 1356738066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 22993) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 114396) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2022-10-02 |