NPI | 1902429558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 21726) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 106092) |
Enumeration Date | 2020-05-18 |
Last Update Date | 2023-01-11 |