| NPI | 1649721234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 22014) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 020614-1) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2022-04-20 |