| NPI | 1942376298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501010190) |
| Additional Taxonomies | 2251E1200X Physical Therapist Ergonomics (Licence: MI 5501010190) |
| 2251N0400X Physical Therapist Neurology (Licence: MI 5501010190) | |
| 2251S0007X Physical Therapist Sports (Licence: MI 5501010190) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: MI 5501010190) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2022-10-19 |