NPI | 1366002719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 23856) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
390200000X Student in an Organized Health Care Education/Training Program | |
101Y00000X Counselor | |
106S00000X Behavior Technician | |
Enumeration Date | 2019-06-18 |
Last Update Date | 2024-07-08 |