| NPI | 1477294346 |
|---|---|
| Former Name | GEOFFREY GEORGE JASINSKI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019836) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 300838) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-05-25 |