| NPI | 1033795810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 025336) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 21905) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-03-22 |