| NPI | 1265674063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 0295431) |
| Additional Taxonomies | 2251C2600X Physical Therapist, Cardiopulmonary (Licence: NY 0295431) |
| 2251E1200X Physical Therapist, Ergonomics (Licence: NY 0295431) | |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: NY 0295431) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: NY 0295431) | |
| 2251H1200X Physical Therapist, Hand (Licence: NY 0295431) | |
| 2251H1300X Physical Therapist, Human Factors (Licence: NY 0295431) | |
| 2251N0400X Physical Therapist, Neurology (Licence: NY 0295431) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NY 0295431) | |
| 2251S0007X Physical Therapist, Sports (Licence: NY 0295431) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NY 0295431) | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |