| NPI | 1730352162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 10237) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: FL PT 10237) |
| 2251H1300X Physical Therapist, Human Factors (Licence: FL PT 10237) | |
| 2251N0400X Physical Therapist, Neurology (Licence: FL PT 10237) | |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |