| NPI | 1538995303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA02319600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P23426) |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2025-04-01 |