| NPI | 1073629077 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: NJ 40QA00988600) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40qa00988600) |
| 2251C2600X Physical Therapist, Cardiopulmonary (Licence: NJ 40qa00988600) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2011-01-24 |