| NPI | 1548235542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1200X Physical Therapist, Ergonomics (Licence: MO 2001009684) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2001009684) |
| 2251S0007X Physical Therapist, Sports (Licence: MO 2003004222) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2024-03-20 |