| NPI | 1700216579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV 017-0882) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 018496) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2023-08-21 |