| NPI | 1174637847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 019093) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 019093) |
| 2251H1200X Physical Therapist, Hand (Licence: NY 019093) | |
| 2251N0400X Physical Therapist, Neurology (Licence: NY 019093) | |
| 2251S0007X Physical Therapist, Sports (Licence: NY 019093) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2011-05-13 |