| NPI | 1750123253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT61675911) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 27865) |
| 225X00000X Occupational Therapist (Licence: TX 125379) | |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2026-02-17 |