| NPI | 1598890329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225C00000X Rehabilitation Counselor |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: MN 102060) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2025-09-11 |