| NPI | 1467610501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1053627) |
| Additional Taxonomies | 2251H1200X Physical Therapist Hand (Licence: TX 9310000326) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |