| NPI | 1316830383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist Geriatrics (Licence: CA 36146) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: OR 65588) |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |