| NPI | 1376272542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NH EL31279) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 025258) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2024-07-07 |