| NPI | 1699931931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT60010489) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2024-06-21 |