| NPI | 1619378825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 019077) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00834900) |
| Enumeration Date | 2014-09-07 |
| Last Update Date | 2022-09-30 |