| NPI | 1538469911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 003915) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 5753679) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2023-12-14 |