| NPI | 1598978181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 20095) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT 33095) |
| 225100000X Physical Therapist (Licence: DE J1-0001623) | |
| 225100000X Physical Therapist (Licence: GA PT 008721) | |
| 225100000X Physical Therapist (Licence: HI PT 2643) | |
| 225100000X Physical Therapist (Licence: IL 070 015110) | |
| 225100000X Physical Therapist (Licence: IA 03920) | |
| 225100000X Physical Therapist (Licence: NY 028261-1) | |
| 225100000X Physical Therapist (Licence: PA PT 018097) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |