| NPI | 1407831290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 1042819) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT00003397) |
| 225X00000X Occupational Therapist (Licence: MD 04482) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2021-12-29 |