| NPI | 1952734725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 9235) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 018219) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2025-11-19 |