| NPI | 1699737106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251H1200X Physical Therapist, Hand (Licence: TN 0000009817) |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand (Licence: GA PT013817) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2019-01-11 |