| NPI | 1437938552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XM0800X Occupational Therapist, Mental Health (Licence: CA 25196) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 25196) |
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2026-06-18 |