| NPI | 1629799945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 024572) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |