| NPI | 1457530537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019017) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J10002349) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2024-12-30 |