| NPI | 1801412002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 18767) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 18767) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2023-11-01 |