| NPI | 1912229493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 11129) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NC 7409) |
| 225X00000X Occupational Therapist (Licence: FL 14049) | |
| 225X00000X Occupational Therapist (Licence: ZZ 0000394) | |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2010-02-24 |