| NPI | 1760089304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 26834) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CA 4236) |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2024-10-09 |