| NPI | 1477738391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: ME 1430) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: ME 1430) |
| 2251S0007X Physical Therapist, Sports (Licence: ME 1430) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2015-06-25 |