| NPI | 1609222322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: NY 025981) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 008924) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2022-07-13 |