| NPI | 1497931802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00201600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 46TR00201600) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2021-08-13 |