| NPI | 1326513482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1648) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 105770) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2023-01-12 |