| NPI | 1114230414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251C2600X |
| 2251E1200X Physical Therapist, Ergonomics | |
| 2251G0304X Physical Therapist, Geriatrics | |
| 2251H1200X Physical Therapist, Hand | |
| 2251H1300X Physical Therapist, Human Factors | |
| 2251N0400X Physical Therapist, Neurology | |
| 2251P0200X Physical Therapist, Pediatrics | |
| 2251S0007X Physical Therapist, Sports | |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2012-08-15 |