| NPI | 1598374373 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 27053)  | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 124591)  | 
| 225X00000X Occupational Therapist (Licence: FL 20935)  | |
| Enumeration Date | 2020-07-28 | 
| Last Update Date | 2024-11-22 |