| NPI | 1689841827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT00004525) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |