| NPI | 1568518041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1241500) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 005464) |
| 171100000X Acupuncturist (Licence: FL AP3587) | |
| 225100000X Physical Therapist (Licence: NY 026635) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT21614) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-12-29 |