| NPI | 1033371737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist Geriatrics (Licence: NY 059980) |
| Additional Taxonomies | 2251N0400X Physical Therapist Neurology (Licence: NY 059980) |
| 2251P0200X Physical Therapist Pediatrics (Licence: NY 059980) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: NY 059980) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |