| NPI | 1396059655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 006886) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 006886) |
| 225X00000X Occupational Therapist (Licence: FL OT15825) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2022-07-21 |