| NPI | 1427418037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: VA 2305209990) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT013532) |
| 225100000X Physical Therapist (Licence: DC PT871931) | |
| 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: GA PT013532) | |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2025-02-26 |