| NPI | 1477004596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 019000) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 16280) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |