| NPI | 1598435398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 12387) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 12387) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2023-04-24 |