| NPI | 1952662843 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 101822) |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health (Licence: MN 101822) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2016-08-08 |