| NPI | 1891452330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ OTH-008854) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR01031700) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2024-05-03 |