| NPI | 1447227087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007650) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05006801A) |
| 225100000X Physical Therapist (Licence: OH 009254) | |
| 225100000X Physical Therapist (Licence: TX 1311760) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2023-12-20 |