| NPI | 1962409722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH #0960) |
| Additional Taxonomies | 2251E1200X Physical Therapist Ergonomics (Licence: NH 0960) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-09-09 |