| NPI | 1710527742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251H1200X Physical Therapist, Hand (Licence: NY 038936) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 038936) |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2021-04-09 |