| NPI | 1073658183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 225C00000X Rehabilitation Counselor | |
| 226300000X Kinesiotherapist | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2024-02-14 |