| NPI | 1255663167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 24818) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00506300) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2024-05-04 |