| NPI | 1154913226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: NY 045766) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: WA PT61112990) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2023-10-30 |