| NPI | 1366029688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA OTA002734) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: GA OTA002734) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-07-16 |