| NPI | 1932195807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 103246) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: IA 2435) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2014-05-14 |