| NPI | 1518779214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR01217400) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NJ 46TR01217400) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: NJ 46TR01217400) | |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-28 |