| NPI | 1821466996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CA 4346) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 008688-1) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2018-06-07 |