| NPI | 1528461050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 14448) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: CA 14448) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2020-10-14 |