| NPI | 1437334547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0002306) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE JT0000684) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2012-06-13 |