| NPI | 1861699639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MO 01248) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: MO 01248) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2018-04-23 |