| NPI | 1407740293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA CP044415T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH12228) |
| Enumeration Date | 2025-06-05 |
| Last Update Date | 2025-06-05 |