| NPI | 1841656618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 2251C2600X Physical Therapist, Cardiopulmonary |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |