| NPI | 1437700119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251C2600X |
| 2251G0304X Physical Therapist, Geriatrics | |
| 2251N0400X Physical Therapist, Neurology | |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2025-06-20 |