| NPI | 1144935578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XE0001X Occupational Therapist Environmental Modification (Licence: NY 017168) |
| Additional Taxonomies | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: NY 017168) |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2023-01-19 |