| NPI | 1578354411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 030126) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 030126) |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |