| NPI | 1295739795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1100497) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 321) |
| 227800000X Respiratory Therapist, Certified (Licence: KS 16-00580) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2014-12-18 |