| NPI | 1467027755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00262900) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC011311) |
| 225X00000X Occupational Therapist (Licence: MA 11739) | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |