NPI | 1366862351 |
---|---|
Former Name | MICHAEL AMUNDSON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NM 2773) |
Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 211132) |
Enumeration Date | 2014-04-17 |
Last Update Date | 2014-04-17 |