| NPI | 1346750361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 025952-01) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2022-07-08 |