| NPI | 1639298672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NJ 46TR00183300) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |