| NPI | 1205023272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NC 7820) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2024-04-15 |