| NPI | 1740692961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 16631) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 11256) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2024-08-29 |