| NPI | 1730599101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: CA 12865) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 12865) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2020-05-11 |