| NPI | 1821505249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 16338) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 17795) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2023-10-10 |