| NPI | 1750407706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00266500) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 010831-1) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2008-07-20 |