| NPI | 1720873623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR01239000) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-04-23 |