| NPI | 1528218963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 011004) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 579433) |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 579433) | |
| 163WC1500X Registered Nurse, Community Health (Licence: NY 579433) | |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NY 011004) | |
| 225XG0600X Occupational Therapist, Gerontology (Licence: NY 011004) | |
| 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: NY 011004) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2013-01-17 |