| NPI | 1467124578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC PT11400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37509) |
| 225100000X Physical Therapist (Licence: VA 2305215729) | |
| 225100000X Physical Therapist (Licence: NC P23138) | |
| 225100000X Physical Therapist (Licence: GA PT017480) | |
| 225100000X Physical Therapist (Licence: AL PTH11808) | |
| 225100000X Physical Therapist (Licence: KS T-W0049-3) | |
| 225100000X Physical Therapist (Licence: PA PT032334) | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2025-02-13 |