| NPI | 1205935251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 2719) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2025-05-07 |