| NPI | 1285010355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 103586) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2023-10-27 |