| NPI | 1316441140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 024231) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 008896-1) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2020-04-29 |