| NPI | 1811315955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 037490-1) |
| 225100000X Physical Therapist | |
| 2251H1200X Physical Therapist, Hand | |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2014-04-05 |
| Last Update Date | 2019-02-02 |