| NPI | 1053945808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 022974) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00852000) |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-08-03 |