| NPI | 1598732620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 018320) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 018320) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2007-07-08 |