| NPI | 1801643010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: NJ 46TR01127300) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NJ 46TR01127300) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-05-06 |