| NPI | 1457308405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT15164) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT00002537) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2023-01-25 |