| NPI | 1386072478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT19408) |
| Additional Taxonomies | 2279G1100X Respiratory Therapist, Registered, General Care (Licence: FL RT11880) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2020-10-20 |