| NPI | 1619583051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: NC P19894) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2023-02-09 |