| NPI | 1194826479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008747) |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-12-28 |