NPI | 1427242478 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: MN 102028) |
Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: ND 285) |
Enumeration Date | 2007-09-04 |
Last Update Date | 2018-03-21 |