| NPI | 1730945544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 25318) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: LA OTT.200841) |
| 225X00000X Occupational Therapist (Licence: TX 123005) | |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-02-28 |