| NPI | 1649406539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TN 1861) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CA OTA1178) |
| 225200000X Physical Therapy Assistant (Licence: CA AT6722) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2010-01-15 |