| NPI | 1891190476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00505600) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 11302) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NJ 46TR00505600) | |
| Enumeration Date | 2014-10-25 |
| Last Update Date | 2014-10-25 |