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 |