| 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 |