| NPI | 1902465222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA 60943964) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 421362) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2025-02-05 |