| NPI | 1396886529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: GA PT016313) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01210900) |
| 225100000X Physical Therapist (Licence: PA PT109858) | |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: NY 025272) | |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: AL PTH10732) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2022-11-17 |