| NPI | 1861548281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: NC P18116) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NC P18116) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2024-10-02 |