| NPI | 1437336492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV PT2193) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 34615) |
| 225100000X Physical Therapist (Licence: NV 2193) | |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2012-04-17 |