| NPI | 1396041992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA 60347111) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2018-12-17 |