| NPI | 1396905618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0006082) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT00003965) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2026-06-26 |