| NPI | 1013429976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251C2600X Physical Therapist, Cardiopulmonary |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26744) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2017-11-01 |