| NPI | 1740941616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 026079) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2023-09-22 |