| NPI | 1821471871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 104946) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2020-08-11 |