| NPI | 1558308528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 37) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 100354) |
| 225X00000X Occupational Therapist (Licence: SD 76) | |
| 225X00000X Occupational Therapist (Licence: AZ 1601) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-12-20 |