| NPI | 1558389783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0000936) |
| 225100000X Physical Therapist (Licence: DE J10000936) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-10-02 |