| NPI | 1487936852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT60249131) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 287331) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2019-03-15 |