| NPI | 1699784009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 13548) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00299800) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-11-16 |