| NPI | 1467656744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist Electrophysiology, Clinical (Licence: NC P14459) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: PA PT010832L) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2018-07-19 |