| NPI | 1306365309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SC 6249) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00641000) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2024-12-05 |