| NPI | 1235579871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1479) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 104487) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2016-06-30 |