| NPI | 1861162711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: NY 025769) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2022-08-19 |