| NPI | 1710713128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: UT 14122070-2401) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-12 |