| NPI | 1306037874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NY 018212) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 004369) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2013-10-26 |