| NPI | 1295007680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: LA 08099) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 08099) |
| 2251E1200X Physical Therapist, Ergonomics (Licence: LA 08099) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: LA 08099) | |
| 2251S0007X Physical Therapist, Sports (Licence: LA 08099) | |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-07-10 |