| NPI | 1144543869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: TX LMT MT108519) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX LMT MT108519) |
| 225700000X Massage Therapist (Licence: TX LMT MT108519) | |
| 225800000X Recreation Therapist (Licence: TX LMT MT108519) | |
| 225X00000X Occupational Therapist (Licence: TX LMT MT108519) | |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-24 |