| NPI | 1427606599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 10148) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 10148) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 022927) | |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2024-12-27 |