| NPI | 1346724259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 028196) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR01128000) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2023-08-25 |