| NPI | 1275029951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 028595) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 009772) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2024-01-03 |