| NPI | 1033388806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WI 2385-026) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 101874) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2014-01-12 |