| NPI | 1427505338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26151) |
| 225100000X Physical Therapist (Licence: IL 070022758) | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2018-04-09 |