| NPI | 1427606599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD 10148) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 022927) |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2024-05-23 |