| NPI | 1588361455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT305449) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD CP024998T) |
| 225100000X Physical Therapist (Licence: GA PT016440) | |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2024-01-09 |