| NPI | 1326281684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT105242) |
| Additional Taxonomies | 225XE1200X Occupational Therapist, Ergonomics (Licence: TX MT105242) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: TX MT105242) | |
| 2251E1200X Physical Therapist, Ergonomics (Licence: TX MT105242) | |
| 2251S0007X Physical Therapist, Sports (Licence: TX MT105242) | |
| 225100000X Physical Therapist (Licence: TX MT105242) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: TX MT105242) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2009-04-15 |