| NPI | 1407508351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MN 201908) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-01-21 |