| NPI | 1427492941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1226699) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: TX 1226699) |
| 2251N0400X Physical Therapist, Neurology (Licence: TX 1226699) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1226699) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2024-02-07 |