| NPI | 1669781639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT 60103836) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: SC PT.6160 PT) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT 34660) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CO 10359) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: ID PT-2233) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: IL 70.017721) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MA 19003) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 8052) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: OR 5517) | |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2010-09-24 |