| NPI | 1306058300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 273Y00000X Rehabilitation Unit (Licence: NJ 46TR00093900) |
| 282N00000X General Acute Care Hospital (Licence: PA oc006025l) | |
| 282NR1301X General Acute Care Hospital, Rural (Licence: NJ 46TR00093900) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2022-03-24 |