| NPI | 1093760670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23639) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J2001723) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-05-06 |