| NPI | 1780658278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 004155) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: NY 004155) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 004155) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2008-06-04 |