| NPI | 1942671664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 102114) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2021-01-28 |