| NPI | 1780701854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 009163-1) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00283000) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2012-08-28 |