| NPI | 1588735948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1139525) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: TX 106486) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-01-24 |