| NPI | 1508870189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: GA PT017062) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: WI 4776-24) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-07-09 |