| NPI | 1265994487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1091213) |
| Additional Taxonomies | 2251E1300X Physical Therapist Electrophysiology, Clinical (Licence: TX 1091213) |
| 2251G0304X Physical Therapist Geriatrics (Licence: TX 1091213) | |
| 2251H1200X Physical Therapist Hand (Licence: TX 1091213) | |
| 2251H1300X Physical Therapist Human Factors (Licence: TX 1091213) | |
| 2251N0400X Physical Therapist Neurology (Licence: TX 1091213) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: TX 1091213) | |
| 2251S0007X Physical Therapist Sports (Licence: TX 1091213) | |
| 2251E1200X Physical Therapist Ergonomics (Licence: TX 1091213) | |
| 2251C2600X Physical Therapist Cardiopulmonary (Licence: TX 1091213) | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2019-04-05 |