| NPI | 1982145272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 021303-1) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 0T18283) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |