NPI | 1528389897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 6014) |
Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 6014) |
2251S0007X Physical Therapist, Sports (Licence: NY 6014) | |
Enumeration Date | 2010-06-21 |
Last Update Date | 2010-06-21 |