| NPI | 1346674843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA01503900) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: NJ 40QA01503900) |
| 2251S0007X Physical Therapist, Sports (Licence: NJ 40QA01503900) | |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2013-09-03 |