| NPI | 1952674186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 103867) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 4943-26) |
| Enumeration Date | 2012-02-19 |
| Last Update Date | 2024-06-28 |