| 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 |