| NPI | 1639211592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 013262) |
| Additional Taxonomies | 225XE1200X Occupational Therapist, Ergonomics (Licence: NY 013262) |
| 225X00000X Occupational Therapist (Licence: NY 013262) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2017-01-31 |