| NPI | 1194026856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 014158) |
| Additional Taxonomies | 226300000X Kinesiotherapist (Licence: NY 014158) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2022-12-23 |