| NPI | 1053412486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: GA PT012370) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: CA PT-26416, EN-43) |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: NC P7769) | |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: AL PT7974) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2024-08-01 |