| NPI | 1932362977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MT PTP-PT-LIC-2055) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MT OTP-OT-LIC-550) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2024-11-13 |