| NPI | 1932702230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC016441) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA OT21613) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-18 |