| NPI | 1548933021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 26219) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: CA 42043) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2025-01-03 |