| NPI | 1922014497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J10000982) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT008915E) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-03-09 |