| NPI | 1982476107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XN1300X Occupational Therapist Neurorehabilitation (Licence: NY 027613-01) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 027613-01) |
| 225XP0200X Occupational Therapist Pediatrics (Licence: NY 027613-01) | |
| 225XR0403X Occupational Therapist Driving and Community Mobility (Licence: NY 027613-01) | |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2023-10-23 |