NPI | 1174920839 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 037044) |
Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
2251G0304X Physical Therapist, Geriatrics | |
Enumeration Date | 2014-11-24 |
Last Update Date | 2014-11-24 |