| NPI | 1093139974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NY 012917) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: NY 012917) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2015-05-20 |