| NPI | 1114120706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 2523) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00506800) |
| 225X00000X Occupational Therapist | |
| 225X00000X Occupational Therapist (Licence: NC 8113) | |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2022-03-23 |