| NPI | 1437183027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV NV1378) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 7043969-2401) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2009-02-12 |