| NPI | 1609820174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CO 9061) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: CO 9061) |
| 2251S0007X Physical Therapist, Sports (Licence: CO 9061) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: CO 9061) | |
| 2251H1200X Physical Therapist, Hand (Licence: CO 9061) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2021-02-16 |