| NPI | 1376225102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR CP024327T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 06907) |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |