| NPI | 1477194702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: CA 23081) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2022-06-04 |