| NPI | 1831289768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ tr00003700) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA oc003431l) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-06-11 |