| NPI | 1053421487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 226300000X Kinesiotherapist (Licence: AZ 1379) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 1379) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-09-06 |