| NPI | 1700167046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 014782) |
| Additional Taxonomies | 225XE0001X Occupational Therapist Environmental Modification (Licence: NY 014782) |
| 225XN1300X Occupational Therapist Neurorehabilitation (Licence: NY 014782) | |
| 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: NY 014782) | |
| 225XP0200X Occupational Therapist Pediatrics (Licence: NY 014782) | |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |