| NPI | 1639589617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00660400) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 46TR00660400) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2024-02-06 |