| NPI | 1053677559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251E1200X Physical Therapist Ergonomics |
| 2251H1200X Physical Therapist Hand | |
| 2251H1300X Physical Therapist Human Factors | |
| 2251S0007X Physical Therapist Sports | |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |