| NPI | 1851022826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NY 010759) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09195600) |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2022-06-21 |