| NPI | 1518530534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 025684) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-20 |