| NPI | 1871877332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT-3117) |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification (Licence: CO OT.0003117) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2021-10-07 |