| NPI | 1427259811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 102314) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1202948) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: TX 1202948) | |
| 2251N0400X Physical Therapist, Neurology (Licence: TX 1202948) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1202948) | |
| 2251S0007X Physical Therapist, Sports (Licence: TX 1202948) | |
| 225100000X Physical Therapist (Licence: TX 1202948) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2015-10-30 |