| NPI | 1679900773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT00004262) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 212384) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |