| NPI | 1609755354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT61664045) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 455860) |
| 225X00000X Occupational Therapist (Licence: CA 22577) | |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2025-08-28 |