| NPI | 1093324204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 5501) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 024725) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-11-11 |