| NPI | 1639185069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MD 16255) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: MD 16255) |
| 2251S0007X Physical Therapist, Sports (Licence: MD 16255) | |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2024-02-13 |