| NPI | 1861675977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: CA 41469) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070016062) |
| 2251G0304X Physical Therapist, Geriatrics | |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2020-06-26 |