| NPI | 1396824579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251E1200X Physical Therapist, Ergonomics (Licence: NJ 40QA0077710) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: NJ 40QA0077710) |
| 2251S0007X Physical Therapist, Sports (Licence: NJ 40QA0077710) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA0077710) | |
| 225400000X Rehabilitation Practitioner (Licence: NJ 40QA0077710) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |