| NPI | 1194994954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WI 1374-026) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 104583) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2017-09-12 |