| NPI | 1811051865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251H1200X Physical Therapist, Hand (Licence: NJ 40QA00800700) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 019359) |
| 225100000X Physical Therapist (Licence: NJ 40QA00800700) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA00800700) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2018-05-17 |