| NPI | 1992342026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR00906200) |
| Additional Taxonomies | 224ZR0403X Occupational Therapy Assistant, Driving and Community Mobility (Licence: FL OT24225) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2023-06-06 |