| NPI | 1407394521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 33473) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 013060) |
| 225100000X Physical Therapist (Licence: CO PTL18236) | |
| 225100000X Physical Therapist (Licence: DC PT2000008) | |
| 225100000X Physical Therapist (Licence: IN 05014481A) | |
| 225100000X Physical Therapist (Licence: IA 110847) | |
| 225100000X Physical Therapist (Licence: MD 28773) | |
| 225100000X Physical Therapist (Licence: MI 5501021581) | |
| 225100000X Physical Therapist (Licence: NY 047246) | |
| 225100000X Physical Therapist (Licence: RI PT03473) | |
| 225100000X Physical Therapist (Licence: TX 1284055) | |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2022-03-25 |