| NPI | 1942612940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NY 017564-1) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: MD 07044) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NC 8849) | |
| Enumeration Date | 2014-05-24 |
| Last Update Date | 2014-05-24 |