| NPI | 1609187277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 032263) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: NJ 40qa01465800) |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2022-12-13 |