| NPI | 1588940381 |
|---|---|
| Other Name | JIM FERNANDES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: NC 12483) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NC p12483) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2023-06-22 |