| NPI | 1558569855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 220996) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT00004421) |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2011-08-03 |