| NPI | 1851844468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025397) |
| Enumeration Date | 2016-07-31 |
| Last Update Date | 2018-12-17 |