| NPI | 1063616944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NH NH3211) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 3211) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2009-06-21 |