| NPI | 1538331996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 9609-1) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: NY 9609-1) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NY 9609-1) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2023-12-27 |