| NPI | 1336676527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 021504-1) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 0215041) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2022-09-15 |