| NPI | 1619833738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT70073754) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 543474) |
| Enumeration Date | 2026-01-02 |
| Last Update Date | 2026-01-02 |