| NPI | 1386723625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 14588) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J10000300) |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: DE J10000300) | |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: MD 14588) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-02-25 |