| NPI | 1619160595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 013244-01) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 013244) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2024-07-24 |