| NPI | 1588906374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT010380) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 13268) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2022-11-15 |