| NPI | 1538207683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 012837) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NY 012837) |
| 251E00000X Home Health (Licence: NY 012837) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2010-12-14 |