| NPI | 1487001954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT61480773) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2016-05-15 |
| Last Update Date | 2023-09-06 |