| NPI | 1487718300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 012505-1) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: NY 012505-1) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 012505-1) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2015-12-10 |