| NPI | 1255431730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 008883-1) |
| Additional Taxonomies | 225XH1300X Occupational Therapist, Human Factors (Licence: NY 008883-1) |
| 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: NY 008883-1) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 008883-1) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2007-07-09 |