| NPI | 1831216563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NH 2728) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 2728) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-05-19 |