| NPI | 1356657605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00329400) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 013365-1) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2012-02-23 |