| NPI | 1639357890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 2384) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: TN 2384) |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2008-02-09 |