| NPI | 1437889755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR01127100) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NC 15016) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2023-06-19 |