NPI | 1750568093 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 37091) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21947) |
2251X0800X Physical Therapist, Orthopedic (Licence: AK 149099) | |
2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0016235) | |
2251X0800X Physical Therapist, Orthopedic (Licence: MA 19391) | |
2251X0800X Physical Therapist, Orthopedic (Licence: NY 044438) | |
2251X0800X Physical Therapist, Orthopedic (Licence: OK 5656) | |
2251X0800X Physical Therapist, Orthopedic (Licence: PA PT028309) | |
2251X0800X Physical Therapist, Orthopedic (Licence: IL 70024945) | |
2251X0800X Physical Therapist, Orthopedic (Licence: CT 12561) | |
Enumeration Date | 2008-01-29 |
Last Update Date | 2020-05-06 |