| NPI | 1003574567 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 105953) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SD 1134) |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2022-03-14 |