| NPI | 1154593812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251E1200X Physical Therapist, Ergonomics (Licence: SC 6768) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: NC 10032) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2021-02-04 |