| NPI | 1760722136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 023429) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 5263) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2019-10-07 |