| NPI | 1366014748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 026951) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 09340) |
| 225X00000X Occupational Therapist (Licence: DC OT200001224) | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2022-08-29 |