| NPI | 1952738973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: NY 030689) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: NJ 40QA01288300) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |