| NPI | 1003076811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00416800) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 013541-1) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |