| NPI | 1346483161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NH 2867) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00033400) |
| 225X00000X Occupational Therapist (Licence: NY 010183) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2019-10-06 |