| NPI | 1699016303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: CA 60635) |
| Additional Taxonomies | 225800000X Recreation Therapist |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2020-10-27 |