| NPI | 1639490253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist Hand (Licence: MN 104047) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 104047) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2021-02-18 |