| NPI | 1538112834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 1156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 02875) |
| 2251E1200X Physical Therapist, Ergonomics (Licence: NE 1156) | |
| 2251E1200X Physical Therapist, Ergonomics (Licence: IA 02875) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: NE 1156) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: IA 02875) | |
| 2251H1300X Physical Therapist, Human Factors (Licence: NE 1156) | |
| 2251H1300X Physical Therapist, Human Factors (Licence: IA 02875) | |
| 2251S0007X Physical Therapist, Sports (Licence: NE 1156) | |
| 2251S0007X Physical Therapist, Sports (Licence: IA 02875) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NE 1156) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: IA 02875) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-10-19 |