| NPI | 1538134093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: PA PT002944l) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: PA DAPT000361) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2015-04-22 |