| NPI | 1972590370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 01214) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: IA 01214) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2024-04-24 |