| NPI | 1790345940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OT-2951) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 20116) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2025-04-11 |