| NPI | 1255586129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 038890) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070010850) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: NY 038890) | |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2018-07-11 |