| NPI | 1750962767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00986100) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: NJ 46TR00986100) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2026-07-24 |