| NPI | 1841688322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 3267) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA DPT 42072) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2016-03-18 |