| NPI | 1225963143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT001159E) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: PA DAPT003637) |
| Enumeration Date | 2026-06-13 |
| Last Update Date | 2026-06-13 |