| NPI | 1518523646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT020851) |
| 225100000X Physical Therapist (Licence: CA 296684) | |
| 225100000X Physical Therapist (Licence: PA PT031961) | |
| 225100000X Physical Therapist (Licence: IL 070028036) | |
| 225100000X Physical Therapist (Licence: MD 25583) | |
| 225100000X Physical Therapist (Licence: TX 1383976) | |
| 225100000X Physical Therapist (Licence: NY 051277) | |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2024-01-30 |