| NPI | 1740222819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 007731-1) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: NY 1041100081) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-04-01 |