| NPI | 1427293273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 005347) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 002641) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2017-04-26 |