| NPI | 1487223970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NJ 1200458281) |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist (Licence: NJ 1200458281) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-11-04 |