| NPI | 1164037263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015430) |
| Additional Taxonomies | 2251C2600X Physical Therapist Cardiopulmonary (Licence: CO PTL.0015430) |
| 2251E1200X Physical Therapist Ergonomics (Licence: CO PTL.0015430) | |
| 2251G0304X Physical Therapist Geriatrics (Licence: CO PTL.0015430) | |
| 2251N0400X Physical Therapist Neurology (Licence: CO PTL.0015430) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: CO PTL.0015430) | |
| 2251S0007X Physical Therapist Sports (Licence: CO PTL.0015430) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: CO PTL.0015430) | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |