| NPI | 1245658806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: PA PT013840L) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: PA PT013840L) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-03-08 |