NPI | 1770996472 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 9053454-2401) |
Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: UT 905354-2401) |
2251G0304X Physical Therapist, Geriatrics (Licence: UT 905354-2401) | |
2251X0800X Physical Therapist, Orthopedic (Licence: UT 905354-2401) | |
Enumeration Date | 2014-06-10 |
Last Update Date | 2024-05-02 |