| NPI | 1962943647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09136700) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2021-11-30 |