| NPI | 1992742001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 2690) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 8851) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2008-07-30 |