| NPI | 1447654298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1345048) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 41849) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2023-03-15 |