| NPI | 1598933426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 35098) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 2759) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2010-11-08 |