| NPI | 1487606224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: PA PT015128) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: PA PT015128) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-04-19 |