| NPI | 1932509601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA 60480509) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 329554) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-08-29 |