| NPI | 1912603762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: NY 011264) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09235000) |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2023-02-03 |