| NPI | 1285660258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT38762) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J10001794) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-12-29 |