| NPI | 1467850255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 019281) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 16670) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |