| NPI | 1003495821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214608) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN CP043806T) |
| 225100000X Physical Therapist (Licence: WA CP043807T) | |
| 225100000X Physical Therapist (Licence: CO CP043700T) | |
| 225100000X Physical Therapist (Licence: WV CP043698T) | |
| 225100000X Physical Therapist (Licence: OH CP043811T) | |
| 225100000X Physical Therapist (Licence: NY 054137) | |
| 225100000X Physical Therapist (Licence: AZ CP044127T) | |
| 225100000X Physical Therapist (Licence: NE CP043805T) | |
| 225100000X Physical Therapist (Licence: MD CP043829T) | |
| 225100000X Physical Therapist (Licence: VT CP043701T) | |
| 225100000X Physical Therapist (Licence: PA PT033242) | |
| 225100000X Physical Therapist (Licence: KY CP043828T) | |
| 225100000X Physical Therapist (Licence: SC CP043699T) | |
| 225100000X Physical Therapist (Licence: TX CP043810T) | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2025-10-01 |