| NPI | 1942912233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 107094) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 8255-26) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2023-03-09 |