| NPI | 1386295806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 027372) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46tr01093200) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2023-07-20 |