| NPI | 1477082618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 104944) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CO 0004663) |
| 225X00000X Occupational Therapist (Licence: WA 60749556) | |
| 225X00000X Occupational Therapist (Licence: TX 117304) | |
| 225X00000X Occupational Therapist (Licence: NC 10768) | |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2022-07-21 |