| NPI | 1437486917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1215176) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 113972) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2012-03-29 |