| NPI | 1700828068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: SC 2472) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 2472) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-02-07 |