| NPI | 1760795207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251C2600X Physical Therapist, Cardiopulmonary (Licence: NC P11867) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P11867) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2018-01-22 |