| NPI | 1144408451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01219600) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00483100) |
| 171100000X Acupuncturist (Licence: NJ 150985) | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2014-02-19 |