| NPI | 1003971466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00259900) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 007313-1) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-08 |