| NPI | 1598809725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 13469) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT32603) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2015-09-23 |