| NPI | 1437451408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 010623) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 37183) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2024-07-26 |