| NPI | 1326477654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1269) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 104428) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2023-02-15 |