| NPI | 1740622109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: AZ 9343) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: CA 39016) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2023-08-14 |