| NPI | 1801420740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 018028) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 004085) |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2020-03-01 |