| NPI | 1528044211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4306) |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand (Licence: OR 4306) |
| 2251H1200X Physical Therapist, Hand | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2012-03-07 |