| NPI | 1558825422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 23325) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2022-03-01 |