| NPI | 1609855584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT008591L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 28516) |
| 225100000X Physical Therapist (Licence: FL PT37706) | |
| 225100000X Physical Therapist (Licence: CT 13167) | |
| 225100000X Physical Therapist (Licence: VT 040.0134292) | |
| 225100000X Physical Therapist (Licence: NY 047404) | |
| 225100000X Physical Therapist (Licence: IN 05014239A) | |
| 225100000X Physical Therapist (Licence: DE J1-0014444) | |
| 225100000X Physical Therapist (Licence: NJ 40QA02064300) | |
| 225100000X Physical Therapist (Licence: MA 25947) | |
| 225100000X Physical Therapist (Licence: PA DAPT001092) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2022-03-22 |