| NPI | 1285760421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 028277) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 35392) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2016-06-28 |