| NPI | 1326278409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01176000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P11342) |
| 225100000X Physical Therapist (Licence: MA 18252) | |
| 225100000X Physical Therapist (Licence: IL 070016674) | |
| 225100000X Physical Therapist (Licence: CO PTL-10260) | |
| 225100000X Physical Therapist (Licence: MT 2213) | |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2009-07-22 |