| NPI | 1396912226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14909-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1253850) |
| 225100000X Physical Therapist (Licence: KY 007322) | |
| 225100000X Physical Therapist (Licence: WA 60582266) | |
| 225100000X Physical Therapist (Licence: MN 10215) | |
| 225100000X Physical Therapist (Licence: MD 28299) | |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2024-11-18 |