| NPI | 1528217098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022528) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J10002379) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2024-06-03 |