| NPI | 1730429168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA 60519411) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 305591) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2021-03-19 |