| NPI | 1013005800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: CA 28098) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: WA PT00010638) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT00010638) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA 28098) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-03-08 |