| NPI | 1174931729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 21438) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00658800) |
| 225X00000X Occupational Therapist (Licence: NY 018927-1) | |
| 225XH1200X Occupational Therapist, Hand (Licence: CA 16557) | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2022-02-14 |