| NPI | 1861735441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 226300000X Kinesiotherapist (Licence: PA 1865) |
| Additional Taxonomies | 226300000X Kinesiotherapist (Licence: VA 1895) |
| 226300000X Kinesiotherapist (Licence: IL 1895) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2023-02-01 |