| NPI | 1336549831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC PT0358) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 301732) |
| 225100000X Physical Therapist (Licence: IA 075063) | |
| 225100000X Physical Therapist (Licence: ME PT5254) | |
| 225100000X Physical Therapist (Licence: KS 11-04958) | |
| 225100000X Physical Therapist (Licence: GA PT012676) | |
| 225100000X Physical Therapist (Licence: NY 038146) | |
| 225100000X Physical Therapist (Licence: SC 7576) | |
| 225100000X Physical Therapist (Licence: VT 040.0134161) | |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2022-03-03 |