| NPI | 1922166743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MD 23792) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 7905) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-04-24 |