| NPI | 1346423886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CO 2785) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 1364) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2007-12-06 |