| NPI | 1861711020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: CA 36753) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2021-04-30 |