| NPI | 1457010704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 026172) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR01020300) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2023-01-06 |