| NPI | 1437244068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: HI 2579) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: CA 32591) |
| 2251X0800X Physical Therapist Orthopedic (Licence: AZ 013745) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: NV 1935) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-09-29 |