| NPI | 1225781800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: NY 053295) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01944800) |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2025-04-17 |