| NPI | 1922464775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OTo-2505) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 15903) |
| Enumeration Date | 2016-01-10 |
| Last Update Date | 2023-08-22 |