| NPI | 1881262814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00978300) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DE U1-0012249) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2022-10-28 |