| NPI | 1275491789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR01277900) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 030853) |
| Enumeration Date | 2026-01-13 |
| Last Update Date | 2026-01-13 |