| NPI | 1043287063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: NY 019204-1) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 019204-1) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2023-10-23 |