| NPI | 1902907488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 011357) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 011357) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2010-04-27 |