| NPI | 1033540380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 132700000X Dietary Manager |
| 225400000X Rehabilitation Practitioner | |
| 226300000X Kinesiotherapist | |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2013-12-11 |